Medicine and Health Sciences Commons^™

Implementation Of Written Discharge Instructions For Common Diagnoses In The Urgent Care Setting, Melissa Kulp, Kristin Elmore

Doctor of Nursing Practice Projects

Abstract

Discharge instructions are an important tool providers use to communicate information to patients about their medical diagnosis after they return to their home environments. When patients understand and follow discharge instructions there are improved outcomes, fewer callbacks, and decreased return visits. The purpose of this quality improvement project were (a) to develop and distribute discharge instructions at or below a sixth-grade reading level, (b) on common diagnoses appropriate for a rural community, (c) decreased the need for subsequent office visits, and (d) decreased call volumes at a rural walk-in clinic. A large-scale literature review was conducted to determine the …

Pediatric Spinal Cord Injury Spasticity Interventions, Zola Lopeman

Symposium of Student Scholars

Muscle spasticity is a common spinal cord injury sequela that causes muscle stiffness, spasms, and painful involuntary contractions. Spasticity can result in difficulty walking, deformed joints, lack of head control, and impairment performing activities of daily living. Spasticity is dynamic and often requires a multifaceted approach to manage symptoms and achieve patient goals. The leading treatment for spasticity is oral Baclofen. Additional treatment methods include electrical stimulation and phenol injections. Oral baclofen is frequently prescribed in combination with these.

Research suggests SCI induced spasticity can cause changes in the muscle. Thus, it is important to assess neural and muscle impacts …

Nursing Considerations For Post-Traumatic Amnesia After A Traumatic Brain Injury, Hannah Grant

Senior Honors Theses

A period known as post-traumatic amnesia (PTA) often follows a traumatic brain injury (TBI). PTA is characterized by anterograde and retrograde amnesia, confusion, disorientation, and agitation. The duration and severity of PTA is a key indicator of the long-term prognosis after a TBI, so proper assessment and nursing care of a PTA patient is crucial. TBIs range from mild to severe, but primarily affect the fronto-temporal lobes. In PTA, both neural lesions and white matter damage within the parahippocampal region can cause PTA. A nurse must perform a thorough assessment of a TBI patient, but, since PTA is a key …

Multi-Disciplinary Biopsychosocial Approach In Low Back Pain Benchmark Study, Liza Beth Cocanougher Short Rn, Ms

MSN Capstone Projects

Low back pain (LBP) is the third most common reason people seek care in America and is the primary reason for missed work days. Working in a pain clinic for eight years and managing research studies directed toward improving low back pain in patients was the motivation for choosing the evidence based intervention in this population. The health care professionals (HCP) in the pain clinic usually have a conversation with the patients who have acute or subacute onset of LBP about their disease and give them a written handout with exercises and ask them to perform these exercises at home. …

Transient Ischemic Attack And Admission To A Dedicated Unit, Bandi Davini

Student Scholarly Projects

Transient ischemic attacks account for admissions of approximately 70% of patients who present to the emergency department with transient vascular symptoms, with an average length of stay of one to seven days, costing, on average, $22,087 (Qureshi et al., 2013). A hospital organization's bed efficiency directly affects quality metrics. Reducing the length of stay in TIA patients by having them admitted to a dedicated unit with whom the staff has experience managing stroke patients and the understanding of specific criteria needing to be met before discharge can directly impact quality metrics and provide cost-effective delivery of care. The PICOT question …

Mystay – Development Of Nurse-Facilitated Condition-Specific Multimedia Resources To Facilitate Patient Participation In Postoperative Care, Jo Mcdonall, Anastasia F. Hutchinson, Natalie Heynesbergh, Bernice Redley, Richard De Steiger, Damien Khaw, Mari Botti

Patient Experience Journal

Improved postoperative outcomes and the global drive toward the provision of patient-centred care underpins efforts to enhance the nature and capacity of patient participation in acute postoperative hospital care. In this paper, we describe the design, framework and processes used to develop a modular, procedure-specific, digital health intervention platform aimed at improving the patient experience and patient participation in care following surgery. The intervention, a multimedia application MyStay, uses bedside delivery of audio-visual and text-based information to engage postoperative patients to better participate in their care. MyStay modules are developed using an iterative, multi-method approach intended to balance procedure-specific best …

Seasonal Affective Disorder Treatment: Light Therapy Versus Ssri Therapy, Gabriella M. Hinde, Hannah Dyer, Ash Werner, Michaela Cisowski

Non-Thesis Student Work

To determine the effect of pharmacological and nonpharmacological treatments for seasonal depression in college students, we asked the following evidence-based PICO question: In college students (ages 18-25) with seasonal affective disorder (SAD), how does SSRI (Selective Serotonin Reuptake Inhibitor) therapy compared to light therapy affect seasonal depression syndrome? Seasonal affective disorder is synonymously used with the terminology seasonal depression due to the clinical manifestations that encompass depression, such as low energy, feelings of sadness, emptiness, or hopelessness. SAD begins in the fall months and peaks in the winter months due to a decrease in Vitamin D and ultraviolet (UV) ray …

Palliative Care Early In The Care Continuum Among Patients With Serious Respiratory Illness An Official Ats/Aahpm/Hpna/Swhpn Policy Statement, Donald R. Sullivan, Anand S. Iyer, Susan Enguidanos, Christopher E. Cox, Morag Farquhar, Daisy J. A. Janssen, Kathleen O. Lindell, Richard A. Mularski, Natasha Smallwood, Alison E. Turnbull, Anne M. Wilkinson, Katherine R. Courtright, Matthew Maddocks, Mary Lynn Mcpherson, J. Daryl Thornton, Margaret L. Campbell, Tracy K. Fasolino, Patricia M. Fogelman, Larry Gershon, Thayer Gershon, Christiane Hartog, Judy Luther, Diane E. Meier, Judith E. Nelson, Elliot Rabinowitz, Cynda H. Rushton, Danetta H. Sloan, Erin K. Kross, Lynn F. Reinke

Research outputs 2022 to 2026

Background:

Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes.

Goals:

This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this.

Methods:

An international and interprofessional expert committee, …

Care Ethics Framework For Midwifery Practice: A Scoping Review, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sadie Geraghty

Research outputs 2022 to 2026

Background:

As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity.

Aim:

The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice.

Method:

The scoping review was conducted according to the Preferred Reporting …

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Nurse-Led Intervention: Implementing Early Mobilization Of Patients In The Intensive Care Unit, Lou A. Hill

Student Scholarly Projects

Practice Problem: Immobility of patients in the hospital intensive care unit can cause longer stays in the intensive care unit and the hospital. Evidence-based early mobilization of patients helps to reduce length of stay (LOS) and avoid many detrimental sequelae, leading to short and long-term debilitation.

PICOT: The PICOT question that guided this project was: In the adult medical and surgical intensive care units (P), how does implementation of a nurse-driven protocol for early mobility (I), affect the LOS in the intensive care units and the LOS in the hospital (O), as opposed to not using a protocol for early …

Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare

Dissertations

Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …

Decreasing Falls On A Locked Inpatient Psychiatric Unit, Terri Fitzpatrick

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to implement an RN nursing staff education on the fall risk assessment tool in effort to decrease falls on one adult locked inpatient psychiatric unit. The assumption was that an educational review of the fall risk variables for inpatient psychiatric patients and subsequent initiation of a fall risk care plan would lead to decreased falls.

Background: A fall can be defined as a sudden unintentional change in position causing an individual to descend to a lower level or onto an object, the floor or ground, or another surface with or without injury. Review …

Increasing Vaccination Rates In The Latin X Communities Through A Public Health Initiative For Increasing Education And Vaccination, Gabriela Carrico

Doctor of Nursing Practice (DNP) Projects

Background: The COVID-19 disease has been found to cause an estimated 570,003 deaths in the United States (Centers for Disease Control and Prevention [CDC], 2021). Statistics showed that the elderly, immunocompromised, and vulnerable populations are the most at risk for this disease. Vaccination is an important aspect of disease prevention in healthcare issues around the world. Vaccination against the COVID-19 prevents this communicable disease from the spread and serious adverse health outcomes.

Problem: The Latin X communities in the Tenderloin District in San Francisco city are confronted with multiple factors that affect their willingness to receive the COVID-19 vaccine. Factors …

Pregnancy Education In Rural Areas, Kayla Tinsley

Doctor of Nursing Practice Scholarly Project

Educating of the pregnancy population before, during and after pregnancy can help to ensure a healthy pregnancy and in turn reduce maternal mortality. The purpose of this research project was to understand education provided in the clinic and hospital setting in a rural area by those who take care of and talk to pregnant women and their support persons. A descriptive research design was utilized to discover the important education topics that are discussed, and the routine tests that are done throughout the pregnancy, during labor and at delivery, and even ask how prepared they feel they are equipped to …

A Quality Improvement Project: Streamlining The Post-Surgical Process In Total Knee And Hip Replacements With An Evidence-Based Guidance And Practice Protocol, Bianca Bullie

Doctoral Projects

ABSTRACT

The rates of total joint replacements, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA), are on the rise in the United States and are expected to rise further in the next 20 years (Singh et al., 2019). Implementing an ERAS protocol coupled with current orthopedic practices will decrease a vast number of postoperative issues such as length of hospital stays, the financial burden on the facility, and overall patient satisfaction. The DNP project proposed a multidisciplinary protocol to standardize the care of patients undergoing THA or TKA and identified if this surgical process would be adopted …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration: An Integrative Review, Purnima Krishna

DNP Qualifying Manuscripts

Purpose/Objectives: This review evaluates the published studies on how post-acute care collaboration ensures a continuum of care and reduces heart failure (HF) readmissions.

Primary Practice Setting: An integrated literature review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. PubMed and Cumulative Index to Nursing and Allied Health were searched for the keywords heart failure AND (post-acute care OR transitional care OR skilled nursing facility OR rehabilitation facility OR home health agency) AND (readmission) AND (care coordination OR collaboration OR interprofessional OR partnerships). Seventy-nine studies were returned, and a reverse reference search yielded four …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Determining The Effectiveness Of Nonpharmacological Treatment Modalities For Adult Patients With Chronic Low Back Pain: An Integrative Review, Sydia Nichole Spence

Doctoral Dissertations and Projects

Chronic low back pain continues to be a major health issue, affecting a significant percentage of the population worldwide. It is one of the major contributors to long-term disability. People with ongoing and recurrent low back pain experience lowered quality of life, long-term disability, lost productivity, and medical costs due to urgent and emergency care visits. Pharmacological treatment modalities often present with serious safety concerns, ineffectiveness due to limited evidence-based studies, undesirable side effects, and the possibility of addiction. Therefore, many clinicians and patients seek alternative approaches to remedy persistent low back pain. Various nonpharmacological therapies have shown favorable results …

Outcomes Of A Covid Mobility Team, Kellie Girardot Msn, Rn, Leann Pancake Mpt, Pt

Nursing Publications

The detrimental effects of immobility are well documented in the literature, yet immobility still plagues the hospitalized adult. As the influx of COVID-19 patients began, patient mobility was further compromised. The purpose of this quality improvement project was to assess the impact of COVID mobility teams, composed of deployed coworkers, on COVID-19–positive and person under investigation patient outcomes. Using mobility teams improved mobility in COVID-positive and person under investigation patients. Increasing patient mobility results in improved patient outcomes by preventing hospital-acquired functional decline, preventing intensive care unit transfers, and decreasing length of stay.

Prophylactic Bioimpedance Spectroscopy For Breast Cancer-Related Lymphedema, Maria M. Marquez

Cohort X

The purpose of this quality improvement project was to implement the standardized use of Bioimpedance Spectroscopy (BIS) for the early detection and management of breast cancerrelated lymphedema (BCRL). BCRL is a common complication of breast cancer treatments resulting from damage to the lymphatic system. While three of every four patients that develop lymphedema typically do so within the first three years after treatment, this complication can develop at any time during or after therapeutic intervention. The National Comprehensive Cancer Network® Clinical Practice Guidelines and others suggest that bilateral baseline limb measurements should be performed on patients at high risk for …

Type 2 Diabetes: Motivational Interviewing Improving Clients’ Dieting And Exercise, Azeb Lema

Cohort X

Background: Type 2 diabetes continues to be a prevalent chronic disease in the world, leading to increased rates of mortality and morbidity. In context of type 2 diabetes (T2D) management, patient empowerment is broadly investigated in the medical literature to date. This concept emphasizes patient autonomy and an individual approach to patient care. In turn, motivational interviewing (MI) is a patient-centered approach that aims to modify patients’ behaviors. The effectiveness of MI in modifying patients’ behaviors diagnosed with T2D has been documented in many sources. MI aims to reduce patients’ internal resistance to change health and lifestyle habits and provide …

Handling Effects In Moderate To Late Preterm Infants In Neonatal Intensive Care, Nancy Brashear

Loma Linda University Electronic Theses, Dissertations & Projects

Providing a thriving environment to preterm infants receiving care in the neonatal intensive care unit is an ongoing area of interest to stakeholders interested in infant health. With advances in monitoring technology, there are new methods to assess the effects of care on preterm infants. Effects of neonatal handling have been analyzed in terms of physiological, behavioral, and pain responses. Further assessment of the effects of handling is needed to determine the impact, if any, on renal and cerebral regional oxygenation in moderate to late preterm infants (34-36 ^6/7 gestation). A conceptual model was developed based on pertinent theoretical frameworks …

Elder Care In The Midst Of The Pandemic: Moving Beyond The Rhetoric, An Interview With Dr. Carole Estabrooks | Entrevue Avec Dre Carole Estabrooks : Les Soins Aux Personnes Âgées Dans Le Cadre De La Pandémie : Aller Au-Delà Du Discours, Florence Myrick, Jacinthe I. Pepin

Quality Advancement in Nursing Education - Avancées en formation infirmière

No abstract provided.

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …

Perceived Risk And Distress Related To Covid-19 In Healthcare Versus Non-Healthcare Workers Of Pakistan: A Cross-Sectional Study, Adeel Abid, Hania Shahzad, Hyder Ali Khan, Suneel Piryani, Areeba Raza Khan, Fauziah Rabbani

Medical College Documents

Background:
Healthcare workers (HCWs) have found themselves and their families more susceptible to contracting COVID-19. This puts them at a higher risk of psychological distress, which may compromise patient care. In this study, we aim to explore the risk perceptions and psychological distress between HCWs and non-healthcare workers (NHCWs) in Pakistan.
Methods:
A cross-sectional study was conducted using an online self-administered questionnaire. Psychological distress was assessed through The Hospital Anxiety and Depression Scale (HADS). Comparisons were made between HCWs (front/backend, students/graduates) and NHCWs related to risk perceptions and stress levels related to COVID19. Following tests for normality (Shapiro–Wilk test), variables …

A Physical Therapy Mobility Checkup For Older Adults: Feasibility And Participant Preferences From A Discrete Choice Experiment, Dalerie Lieberz, Hannah Borgeson, Steven Dobson, Lindsey Ewings, Karen Johnson, Kori Klaysmat, Abby Schultz, Rachel Tasson, Alexandra L. Borstad

Journal of Patient-Centered Research and Reviews

Purpose: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

Methods: Adults over 55 years of age were recruited from the community. In the study’s first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the …

Rehabilitation/Recovery Journals, Judy Schmitt

Library Faculty Works

Comprehensive list of rehabilitation/recovery journals

Cystic Fibrosis, India Hutchison

Nursing Student Class Projects (Formerly MSN)

Cystic fibrosis (CF) is a complex disease caused by an autosomal recessive gene mutation that results in the dysfunction of chloride transport proteins in epithelial tissues. The resultant highly viscous secretions can cause respiratory, gastrointestinal, endocrine, and reproductive complications. Although modern treatment has become more individually targeted and the average life expectancy has increased in recent years, no cure has been discovered. It affects over 80,000 people worldwide, with 30,000 affected individuals living in the United States alone. This poster aims to provide a brief overview of the pathophysiologic processes, treatment therapies, and nursing considerations for Cystic Fibrosis.